REDUCING HIV INFECTION AMONG THE SERIOUSLY MENTALLY ILL

研究表明，4 - 23%的严重精神病患者（SMI） 感染人类免疫缺陷病毒（HIV）。 长期目标 这项研究的目的是降低艾滋病病毒感染率 在接受门诊精神病治疗的重度精神病患者中。 具体 目的是（1）进行有关艾滋病毒相关风险的形成性研究 （2）改善、实施和评估艾滋病毒风险 减少程序与SMI;（3）使用费舍尔和费舍尔（1992年） 信息-动机-行为技能模型来解释可变性 艾滋病相关的危险行为。 研究开始于 6个月的形成性研究;焦点小组和个人 将对25名男子和25名妇女进行定性访谈。 基于 在先前的试点和拟议的形成性工作，一个基于理论， 对文化和临床敏感的减少艾滋病毒风险的干预措施， 将在216名男子和216名妇女中实施“最低工资计划”。 参与者将 被随机分配到（a）艾滋病毒风险降低计划（HIV），（B）a 物质使用减少（SUR），或（c）标准护理（对照）条件。 在基线、干预后以及3个月和6个月时进行评估 随访将测量艾滋病毒相关信息，动机，行为 技能和性行为 我们假设，相对于 分配至SUR和对照条件的受试者， 艾滋病毒干预措施将增加与艾滋病毒有关的（a）信息，（B） 动机，（c）行为技能;和减少（d）风险的频率 性行为 我们进一步假设（e）艾滋病毒感染者 条件将兑换避孕套优惠券，并寻求自愿艾滋病毒抗体 检测率高于SUR和对照组受试者 （f）与治疗条件和物质使用无关 行为，在时间n + 1的HIV预防行为（例如，3-月随访） 将是个人关于传输的信息的函数， 预防艾滋病毒感染，参与艾滋病毒预防的动机， 执行预防所涉具体行为的行为技能 在时间n（例如，（g）信息和动机将 通过行为技能来影响预防行为。 的 这项研究的目的是制定一个降低风险的计划， 社区心理健康组织使用的方法， 艾滋病毒感染者中的男性工作人员。

Research suggests that 4 - 23% of the seriously mentally ill (SMI) are infected with the human immunodeficiency virus (HIV). The long-term aim of the proposed research is to reduce the prevalence of HIV infection among SMI adults who receive outpatient psychiatric care. The specific aims are (1) to conduct formative research regarding HIV-related risk behavior among the SMI; (2) to refine, implement, and evaluate an HIV-risk reduction program with the SMI; and (3) to use Fisher and Fisher's (1992) Information-Motivation-Behavioral Skills model to account for variability in HIV-related risk behavior in the SMI. The proposed research begins with 6 months of formative research; focus groups and individual qualitative interviews will be conducted with 25 men and 25 women. Based upon prior pilot and proposed formative work, a theoretically-based, culturally- and clinically-sensitive, HIV risk reduction intervention for the SMI will be implemented with 216 men and 216 women. Participants will be randomly assigned to (a) an HIV Risk Reduction program (HIV), (b) a Substance Use Reduction (SUR), or (c) a Standard Care (Control) Condition. Assessments made at baseline, post-intervention, and at 3- and 6-month follow-ups will measure HIV-related information, motivation, behavioral skills, and sexual practices. We hypothesize that, relative to participants assigned to the SUR and Control conditions, participants in the HIV intervention will increase HIV-relevant (a) information, (b) motivation, (c) behavioral skills; and decrease (d) the frequency of risky sexual practices. We hypothesize further that (e) participants in the HIV condition will redeem coupons for condoms and seek voluntary HIV-antibody testing at a greater rate than will participants in the SUR and Control conditions; (f) independent of treatment condition and substance use behavior, HIV preventive behavior at time n + 1 (e.g., 3-month follow-up) will be a function of individuals' information about the transmission and prevention of HIV infection, motivation to engage in HIV prevention, and behavioral skills for performing the specific acts involved in prevention at time n (e.g., post-test); and (g) information and motivation will be mediated by behavioral skills to influence preventive behavior. The intent of this research is to develop a risk reduction program that can be used by community-based mental health organizations to reduce the risk of HIV infection among the SMI.